Provider Demographics
NPI:1588062889
Name:HAGEL, DANIEL JAMES (HIS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:HAGEL
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 MT VIEW RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2518
Mailing Address - Country:US
Mailing Address - Phone:605-343-9262
Mailing Address - Fax:605-343-9262
Practice Address - Street 1:617 MT VIEW RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2518
Practice Address - Country:US
Practice Address - Phone:605-343-9262
Practice Address - Fax:605-343-9262
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD424-H237700000X
NE794237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist